Stretching Treatment Options: Yoga and Autism

Photo courtesy of Sharon Manner

Treatments for autism come in all shapes and sizes, and as families well know, what works for one autistic person doesn’t necessarily work for another. Choosing an intervention must be based on an autistic individual’s specific needs and the family’s emotional and fiscal comfort. An increasingly popular choice—which is gaining a greater foothold in the scientific community—is yoga. It doesn’t require expensive medications or time-consuming doctor’s visits. Once learned with the guidance of a specially-trained instructor, it’s a simple movement and breathing activity that researchers say can have far-reaching physical and psychological effects[3]. In fact, a wide range of people on the spectrum can practice yoga, even at home, with limited supervision and with little more than an exercise mat.

Largely in response to parental demand, more yoga teachers than ever before are getting trained to teach classes specifically adapted to students with autism. And in contrast to past years, when most of these students were young tots, yoga-for-autism classes are increasingly geared to older teens and adults. Moreover, there’s a growing recognition that yoga, to be truly effective, must be specifically geared to the unique needs and healing potential of those with ASD, as opposed to a much broader, one-size-fits-all category of “special needs” children[4] with Down’s Syndrome, cerebral palsy, or other developmental disorders.

Not surprisingly perhaps, the pioneers in the burgeoning yoga-autism field tend to be yoga teachers with their own autistic children. Sharon Manner, a 30-year veteran of yoga who’s based in central New Jersey, started working with her autistic daughter, Kerri (now 21) 10 years ago. Like many ASD parents, she was frustrated that Kerri’s doctors had her daughter on several different medications to address sleep, mood, and digestion issues, but despite two hospitalizations, Kerri didn’t seem to be improving much. Manner’s instincts told her that yoga, which focuses on deep breathing techniques to control moods and to quiet the mind, might help. So, after consultation with her fellow yogis, she fashioned a “special” program for Kerri.

Kerri, Manner says, started showing marked improvement after about two years of regular yoga. “She is still on one medication and has a ways to go but she’s on the road to reaching her highest potential,” she says. Manner started by adapting many of yoga’s classical poses, known, as “asanas,” eliminating those that could prove over-stimulating or even dangerous, and focusing instead on yoga’s core breathing exercises (known collectively as pranayama) that help cool down the body’s nervous system, inducing relaxation and stillness, one of the key challenges for those with ASD.

Manner’s success with Kerri quickly led her to consider expanding to other ASD families. With support from her husband, Michael, she set up one of the nation’s first non-profit organization’s focused on autism, Samadhi Sun[5], which sponsors daily yoga-autism classes at nearby schools and even offers special training workshops for veteran yogis who want to learn how to teach yoga to people with ASD. “Our ultimate goal is to open an ‘ashram’—modeled on a sacred Hindu spiritual refuge—where our beautiful people can work, play and succeed,” she says. Manner’s 45-hour teacher training course[6] is drawing students from around the globe, and not just yogis. Many are occupational and physical therapists as well as psychologists that regularly deal with the ASD community and want to expand their range of healing services.

Manner is not alone in her quest. Three thousand miles away, in San Diego, CA, another veteran yogi, Reegan Lessie, whose brother and sister are autistic, is treading a similar path. She teaches a special program, “Adaptive Yoga for Adults with Autism,”[7] primarily to older teens. In fact, she’s preparing to expand her offerings after being contacted two months ago by a local non-profit organization, Blue Roses Girls[8], which works with ASD young women ages 10-18. The group offered yoga on a trial basis in its summer camp last July and was so overwhelmed by the positive response from parents and children that it decided to add yoga to its regular curriculum. The Blue Roses program hopes to be up and running next spring, and could involve as many as 30 participants, including parents, which Lessie says will require a major expansion of her teaching staff.

Beyond modifying class design, there can be other challenges that yoga teachers face in adapting to people on the spectrum. Adults are often a bigger challenge than kids, because they are sometimes less open and may become resistant or even angry, especially if placed in the same class with youngsters. Lessie already teaches one older teenager one-on-one at her own home, which doubles as a private yoga studio. Her assistant, Rob Pastor, says it’s a “constant challenge,” and that the student’s father “often seems to get more out of the class than his son does.”

Lessie, though, who has seen yoga work for her own siblings, remains undaunted. “That’s one of the reasons I wanted to do [yoga] with more adults,” she says. “There’s practically nothing out there. It’s mainly all for kids.”

Part of the challenge in creating opportunities for autistic adults to participate in yoga often comes from dwindling emotional and fiscal resources families face. “When the children are younger, their parents have these hopes. They somehow think that if they do just enough, they can still 'fix’ their kids,” she says. “Then, once their kids are older and can fend for themselves, many parents are tired and [may] not have the energy to keep putting forth that [same] effort.”

Another issue is the cost. “Parents are willing to pay anything to help their children, but adults on the spectrum are usually on a tight budget and most likely cannot afford to pay for a yoga class,” she notes.

Manner also sees special challenges in working with adults, but the upside is that those that agree to participate tend to be more serious about the practice, and less easily distracted. Moreover, once they learn yoga and embrace it, they can often internalize it as a coping tool without further supervision. Her daughter Kerri, she says, has learned how to detach from and “bear witness” to her autism and even gives herself spiritual guidance aloud to relieve her stress.

“She’ll say things like ‘Kerri you need to take a deep breath and need to chant Om now.’ Then she’ll lie down and put her hands in mudra [a prayerful hand clasp in front of her heart]. She doesn’t do the sun salutations or other poses but she’s found a way to achieve ‘mindfulness’ for herself, which is the essence of yoga anyway,” Manner notes.

But how do we know if the yoga is actually working as an intervention? Manner and Lessie admit that much of the evidence gathered so far is highly personal and anecdotal, but many school teachers who work with autistic children say that the kids that practice yoga are calmer and more focused in class, which also affects those around them. A more systematic understanding of the impact of yoga on autism—and recommendations for best teaching practices—will depend on the evidence gathered from more scientific research studies, which are just getting underway.

A study currently in progress in Madison, Wisconsin under the auspices of the highly–respected Center for Investigating Healthy Minds[9] (CIHM) hopes to provide the public with the scientifically validated yoga-autism research it’s been looking for. A year ago, the Center contracted with Spectrum Yoga Therapy (SYT)[10], which has pioneered what it calls a “five-pose recipe” for people with ASD. Each pose is geared to relieving stress and pressure in the “autonomic nervous system,” says founder Scott Anderson, who set up SYT eight years ago. It helped that Madison was already one of the nation’s centers for autism research and treatment hubs[11] and offered a progressive and welcoming yoga-friendly community to boot. “It was a natural match,” he says.

Anderson is a big believer in creating a yoga pedagogy that is “easy to teach and easy for students to remember.” He eschews the use of Sanskrit language and Hindu theology, labeling his poses with clever and practical names like “Gravity Juice,” “Supine Twist,” and “Facilitated Exhale.” Each represents a modified version of a traditional yoga pose that Hindu sages and their followers have sworn by for generations, but radically modified and made more accessible to autistic people. Anderson rarely teaches his classes alone. Thanks to a dedicated corps of volunteers, class attendants guide each student individually through the five-pose sequence and listen carefully and make subtle adjustments as needed.

As a trained physicist as well as a yogi, Anderson says he was naturally concerned to see his autism practice validated scientifically. While much of the current research on yoga and autism relies on small sample sizes[12] or focuses on yoga as part of a broader intervention[13], Anderson and scientists at CIHM have fashioned a research design that calls for 300 research subjects, both children and adults, to be tested 20-30 at a time. The task is especially laborious because unlike many studies that rely on reporting by parents or teachers, Anderson and the Center have created a series of “biological markers” to try to quantify and measure the effects of his five-pose system on heart rate and cortisol levels—the latter a key indicator of stress and anxiety. Some preliminary initial results should be available next spring, but the full study won’t be completed and ready for publication until 2014.

“This could be a real game-changer,” he says.

Manner says she already sees a convergence between yoga autism teachers and the medical establishment in her area. She recently began partnering with a medical “think-tank” in nearby Warren—the Comprehensive Autism Medical Assessment and Treatment Center[14]—that allows parents to take advantage of the full range of available treatments, not confining themselves to drugs and medications alone. She’s on the think-tank’s roster of “virtual experts” and is available to video-conference with ASD families during their medical appointments, offering specific yoga treatment advice, and then arranging for follow-up consultations as needed.

Manner cautions that yoga’s potential—which includes diet and nutrition[15] and the use of medicinal herbs—doesn’t make the practice a “cure-all.” Her daughter was able to discontinue using her stomach pain and sleep medication but still needs her anti-anxiety medication—just less than she once did. Manners attributes this to the efficacy of Kerri’s yoga practice, but states that, “In no way do we recommend that anyone stop taking their meds. Hopefully, what will happen over time is that as the body comes into greater balance, the need for them will be greatly reduced.” (Any changes to medication protocol should be done under the supervision of a qualified physician.)

Skeptics in the medical establishment may question the helpfulness of yoga, but Manner states that her experience and that of other pioneering yogis already offers powerful evidence that yoga “works.” Lessie concurs. “There is no doubt in my mind that yoga can be a tool that [builds] the bridge for so many adults on the spectrum to feel more comfortable in their bodies as well as creating a social environment to bring them out of isolation,” she says. And Lessie points out that part of yoga’s effectiveness may simply have to do with providing people with ASD an opportunity to take a breath and be themselves. “Yoga can be just simple laughter or a smile,” she adds. “It’s about connecting with the self. In this sense, people on the spectrum have more to teach us than we can possibly offer them. They are the essence of yoga. To be in the moment.“